High-dose-rate remote afterloading irradiation of carcinoma of the cervix in Hong Kong: unexpectedly high complication rate

Clin Oncol (R Coll Radiol). 1992 May;4(3):186-91. doi: 10.1016/s0936-6555(05)81087-8.

Abstract

One hundred and thirty-six patients with biopsy-proven carcinoma of cervix were treated with external beam irradiation to the whole pelvis (46 Gy in 23 fractions) and three weekly applications of high-dose-rate (HDR) intracavitary brachytherapy of 7 or 8 Gy per fraction to point A (2 cm above and 2 cm lateral to the cervical os). The actuarial 5-year survival rate was 72% (Stage IB 85%; IIA 64%; IIB 70%; IIIA 25%; IIIB 53%). Patient age above 61 years and Stage III disease were adverse determinants for survival as shown by multivariate analysis. Late complications developed in 47% (65/137) of patients. Grade 3 or above complications occurred in the bladder, small bowel and sigmoid colon/rectum in 5%, 3% and 7% of patients, respectively. The most significant determinant of severe rectal complications was the addition of a lower vaginal tandem (P less than 0.01); the other determinants of rectal complications included a uterine length greater than 5 cm, a total biologically effective dose to the rectum of more than 120 Gy3 and Stage III disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects*
  • Brachytherapy / methods
  • Carcinoma / pathology
  • Carcinoma / radiotherapy*
  • Carcinoma / secondary
  • Cesium Radioisotopes / therapeutic use
  • Cobalt Radioisotopes / therapeutic use
  • Female
  • Hong Kong
  • Humans
  • Intestine, Large / radiation effects
  • Intestine, Small / radiation effects
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pelvis / radiation effects
  • Radiation Injuries / etiology
  • Radiotherapy / adverse effects
  • Radiotherapy / methods
  • Radiotherapy Dosage
  • Rectum / radiation effects
  • Survival Rate
  • Urinary Bladder / radiation effects
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / radiotherapy*

Substances

  • Cesium Radioisotopes
  • Cobalt Radioisotopes